Worldincentivenexus.com Faxable Survey

Professional Profile for:

I am completing this profile because: (check one)

__I want to be considered for the site inspection trip going to _______________ on ____________(date)

__I would like to RSVP for the showcase event titled:
__________________________________________ which will happen: ____________ (date)

__I am requesting a proposal for:_________________________________________________________

_____________________________________________________________________________

Name ________________________ Title __________________________

Company __________________ Street ___________________________________

City ________________________ State ___ Postal Code _____ Country _____

Phone ________________________ Fax ______________________

Email ________________________ Web URL __________________________

1. How many programs of these sizes do you plan each year? (Fill in the amount.)

Under 50 attendees	_____	50-100 attendees	_____	100-250 attendees	_____
250-400 attendees	_____	400-1,000 attendees	_____	over 1,000 attendee	_____

2. Type of Programs: Of all the planning you do what percentage is in each meeting type?

Incentives	____ %	Meetings	____ %	Board Meetings	____ %	Training	____ %
Special Events	____ %	Conventions	____ %	Adventure Programs	____ %	Other	____ %

3. Please tell us about your most recent completed programs.

Month/Year	Type of Program	Number of Attendees	Location
____________________	____________________	____________________	____________________
____________________	____________________	____________________	____________________
____________________	____________________	____________________	____________________
____________________	____________________	____________________	____________________

4. Tell us about future planned meetings/incentives.

Month/Year	Type of Program	Number of Attendees	Location
____________________	____________________	____________________	____________________
____________________	____________________	____________________	____________________
____________________	____________________	____________________	____________________
____________________	____________________	____________________	____________________

5. Location for meetings/incentives: Which of the following locations may be considered in the next 6-12 months? (Please check all that apply.)

__ San Francisco	__ Northern California	__ Other Calif	__ Hawaii
__ Alaska	__ Other U.S.A.	__ Canada	__ Mexico
__ Central America	__ South America_	__ Europe	__ Africa_
__ Middle East	__ Asia_

6.Are there any other locations which may be of interest in the next 6-12 months? Please list them below: _______________________________________________________________________________

__________________________________________________________________________________________

6. Would you prefer we contact you via phone, fax or email? q Phone q Fax q Email

Please fax survey to (707) 869-8012. Thank you.